Acute effects of smoking on left ventricular function and neuro-humoral responses in patients with known or suspected ischaemic heart disease

Effect of Exposure to Second-Hand Smoke on the Quality of Life: A Nationwide Population-Based Study from South Korea

Background

Although exposure to second-hand smoke (SHS) has been associated with various medical conditions, only limited data are available on its association with health-related quality of life (HRQOL), particularly data obtained with the EQ-5D or EQ visual analogue scale (VAS).

Methods

This cross-sectional study evaluated 10,532 adult never-smokers who participated in the fifth Korea National Health and Nutrition Examination Survey. By using linear regression models to adjust for possible confounders and incorporating survey weights in analyses, the association between exposure to SHS and HRQOL—measured with the EQ-5D index and the EQ-VAS score—was evaluated. Data were further stratified by the amount of exposure time.

Results

After weighted analysis and adjustment, exposure to SHS was significantly associated with lower measures on the EQ-5D index (β = −0.007, P = 0.005) and EQ-VAS score (β = −1.936, P < 0.001). When comparing the unexposed group with the groups exposed <2h/day and ≥2h/day, exposure to a longer duration of SHS was significantly associated with lower scores on the EQ-5D index and the EQ-VAS score.

Conclusion

In conclusion, exposure to SHS was associated with reduced HRQOL measured by the EQ-5D index and EQ-VAS score, revealing a dose-response relationship.

Acute haemodynamic effects of cigarette smoking in healthy young subjects

BACKGROUND

Invasive studies in middle-aged patients suggest an acute adverse haemodynamic effect of smoking.

AIMS

To study acute changes in blood pressure (BP), cardiac output, peripheral resistance and aortic compliance following cigarette smoking in healthy young subjects.

METHODS

Using a non-invasive photoplethysmographic technique we compared the effects of smoking one cigarette with sham smoking in 12 healthy volunteers (22-25 years). Data was analysed using JMP version 5.0.

RESULTS

In contrast to sham smoking there was a prompt increase in blood pressure with a maximum effect at 15 min (123 +/- 7/75 +/- 5 to 143 +/- 6/86 +/- 6 mmHg, mean +/- SEM, p < 0.01) which is attributed to a rise in cardiac output (p < 0.05) rather than changes in peripheral vascular resistance. There was also a significant (p < 0.05) increase in heart rate and a reduction in aortic compliance.

CONCLUSION

These results suggest that healthor young age do not protect from the adverse effects of smoking.

Ethnic differences in arterial stiffness and wave reflections after cigarette smoking

BACKGROUND

Smoking increases plasma nicotine. Nicotine releases catecholamines and alters arterial distensibility. The nicotine intake per cigarette is greater and serum cotinine levels, the proximate metabolite of nicotine, are higher in Blacks than in Whites. We tested the hypothesis that cigarette smoking increases the pulse wave velocity (PWV), a marker of arterial stiffness, and the augmentation index (AI), a measure of wave reflection, more in Blacks than in Whites.

METHODS

We matched Black (n = 30) and White (n = 30) smokers for age, gender, body mass index and height. We determined carotid-femoral PWV (PWVCF) and carotid-radial PWV (PWVCR) (Complior), the AI derived from the aortic pressure waveform (applanation tonometry, Sphygmocor), blood pressure, heart rate (HR) and cotinine levels before and after cigarette smoking. We also performed measurements in 16 participants after sham smoking.

RESULTS

Smoking increased the AI, PWVCF and PWVCR in the whole population (all P < 0.05, n = 60). Increases in the AI and PWV were positively related to serum cotinine levels (all P < 0.05). Smoking increased serum cotinine (P = 0.01) and mean blood pressure (P = 0.03) more, but raised the HR to a lesser extent, in Blacks [+8 +/- 4 versus +13 +/- 6 beats/min in Whites (mean +/- SD), P = 0.01]. Blacks disclosed larger increases in AI adjusted for HR (Blacks, +7.2 +/- 8 versus Whites, +4.4 +/- 8%; P = 0.03), PWVCF (Blacks, +1.1 +/- 0.2 versus Whites, +0.6 +/- 0.3 m/s; P < 0.01) and PWVCR (Blacks, +1.4 +/- 0.1 versus Whites, +0.7 +/- 0.4 m/s; P < 0.01) normalized for the mean blood pressure. No changes were observed with sham smoking.

CONCLUSIONS

Smoking acutely increases the PWV and AI in Blacks more than in Whites. Differences in nicotine metabolism and beta-adrenergic sensitivity could explain these findings.